Qual Saf Health Care
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Qual Saf Health Care · Dec 2010
A patient-centred instrument for assessment of quality of breast cancer care: results of a pilot questionnaire.
In several breast cancer research environments, there was a need to develop a questionnaire that would (1) provide data on how breast cancer patients experience healthcare services, (2) address issues corresponding with patients' needs and expectations and (3) produce useful data for quality assessment and improvement projects aimed at breast cancer care. This article describes the first part of the quantitative process of item selection, instrument construction and optimisation based on the results of a pilot questionnaire. ⋯ In this study, the number of items to be included in the self-administered questionnaire was reduced. The resulting set of items that determines patients' perceptions on quality of breast cancer care is easy to complete and enables anonymous responses. Further research can be aimed at establishing the reliability of the current questionnaire.
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Qual Saf Health Care · Dec 2010
ReviewQuality assessment of clinical practice guidelines in perioperative care: a systematic appraisal.
Surgical care is an important burden in healthcare, and the complications and harm related to surgery are of special concern. Clinical practice guidelines in perioperative care should provide the opportunity to minimise these risks and improve surgical outcomes, but their quality has not yet been evaluated systematically. ⋯ The quality of guidelines for perioperative care is moderate. Measures should be taken to guarantee that CPGs are based on the best available evidence and rigorously developed and reported. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.
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Qual Saf Health Care · Dec 2010
Medication reconciliation in the emergency department: opportunities for workflow redesign.
To examine the role of workflow redesign to improve medication reconciliation at four Washington State community hospital emergency departments. ⋯ Ideas for an optimal workflow to generate a medication list include involving patients and utilising clerical staff to a greater extent in medication information gathering, identifying and flagging patients with missing medication information, and gathering only the medication information needed to make clinical decisions in the emergency department.
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Qual Saf Health Care · Dec 2010
The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support.
The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. ⋯ The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.
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Qual Saf Health Care · Dec 2010
Intensive nursing work schedules and the risk of hypoglycaemia in critically ill patients who are receiving intravenous insulin.
Nurses in the intensive care unit (ICU) commonly work frequent 12 h shifts, potentially leading to fatigue and reduced vigilance. The authors hypothesised that rates of hypoglycaemia in patients receiving an insulin infusion would be associated with the intensity of work of the bedside nurse in the preceding 72 h. ⋯ Intensive nursing work schedules are associated with hypoglycaemic events in ICU patients.